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Readmission and Reoperation After Surgery for Pelvic Organ Prolapse

Hokenstad, Erik D. MD; Glasgow, Amy E. MHA; Habermann, Elizabeth B. PhD; Occhino, John A. MD

Female Pelvic Medicine & Reconstructive Surgery: March/April 2017 - Volume 23 - Issue 2 - p 131–135
doi: 10.1097/SPV.0000000000000379
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Objectives We aimed to determine the rates of readmission and reoperation for patients undergoing surgery for pelvic organ prolapse (POP).

Methods The American College of Surgeons National Surgical Quality Improvement Program Participant User File was used to select all surgeries performed for POP from 2012 through 2014. The cohort was then reviewed for unplanned readmissions and unplanned reoperations within 30 days of POP surgery. Patient and procedural factors associated with readmission or reoperation were compared using χ2 analyses and Student t test. Multivariable logistic regression determined independent risk factors for both readmission and reoperation.

Results A total of 23,419 patients underwent surgery for POP. Of these, there were 435 (1.9%) readmissions and 341 (1.5%) reoperations within 30 days. Median numbers of days from index procedure to readmission or reoperation were 9 and 8 days, respectively. Those who were readmitted had higher American Society of Anesthesia (ASA) scores, longer operative times, and longer lengths of stay than those who were not readmitted (all P < 0.001). Patients who underwent unplanned reoperation also had higher ASA scores, longer operative times, and longer lengths of stay than those who did not undergo reoperation (all P < 0.01). The most common reasons for readmission were surgical site infection (SSI) (19.3%) and non-SSI (15.9%). The most common reason for reoperation was urologic (27.6%) such as cystoscopy or stent placement.

Conclusions Readmission and reoperation rates are relatively low for patients undergoing surgery for POP. Infection, both SSI and non-SSI, accounted for 35.2% of readmissions. Identification of ASA score of 3 or higher, longer total operating time, and increased length of stay is associated with unplanned readmission and reoperation.

From the *Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN; and †Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.

Reprints: John A. Occhino, MD, Division of Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: Occhino.john@mayo.edu.

The authors have declared they have no conflicts of interest.

Author contributions: Erik D. Hokenstad: project development, data collection, and manuscript writing; Elizabeth B. Habermann: project development and manuscript writing/editing; Amy E. Glasgow: data analysis and manuscript editing; and John A. Occhino: project development and manuscript writing/editing.

Presented at the 37th Annual Scientific Meeting of the American Urogynecologic Society, Denver, CO.

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